openapi: 3.2.0 info: title: Optum Common Facility Revenue Codes API description: MicroService that contains Optum module-related information contact: name: Ken Kracker email: ken.kracker@optum.com version: v1.0 servers: - url: /v1/optumcommonms tags: - name: Revenue Codes API paths: /api/optum/facility/revenue-procedure-cross-codes/{rev-code}: get: tags: - Revenue Codes API summary: Fetches procedure codes for corresponding revenue code operationId: getProcCodesForRevenueCode parameters: - name: rev-code in: path description: Revenue Code required: true schema: type: string example: '0250' - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: limit in: query required: false schema: type: integer format: int32 default: 50 - name: sort in: query description: Any of these values (code,-code) are allowed. required: false schema: type: array items: type: string default: - code - name: filter in: query required: false schema: type: string - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetches procedure codes for corresponding revenue code content: application/json: example: content: - code: A9270 description: Noncovered item or service tobCode: '012' tobDescription: Hospital Inpatient (Medicare Part B only) note: 'For Medicare claims: This code may be used for items and services associated with an ABN that do not have specific HCPCS codes assigned. Report under any appropriate revenue code. Other payers: This code is by definition a noncovered item or service.' codeType: hcpcs - code: A9270 description: Noncovered item or service tobCode: '013' tobDescription: Hospital Outpatient note: 'For Medicare claims: This code may be used for items and services associated with an ABN that do not have specific HCPCS codes assigned. Report under any appropriate revenue code. Other payers: This code is by definition a noncovered item or service.' codeType: hcpcs totalCount: 2 '400': description: Bad request content: application/json: example: error: - sort parameter value should be from list of [code, -code] warning: null info: null '500': description: Internal server error content: application/json: example: timestamp: '2023-07-27T08:10:07.573+00:00' status: 500 error: Internal Server Error message: 'Request processing failed: java.lang.IllegalArgumentException: Page size must not be less than one' path: /optumcommonms/api/optum/facility/revenue-procedure-cross-codes/0255?page=-1 security: - bearerAuth: [] /api/optum/facility/procedure-revenue-codes/{cpt-hcpcs-code}: get: tags: - Revenue Codes API summary: Fetches revenue codes for corresponding procedure code operationId: getRevenueCodesForProcCode parameters: - name: cpt-hcpcs-code in: path description: Cpt or HCPCS Code required: true schema: type: string example: 99213 - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: limit in: query required: false schema: type: integer format: int32 default: 50 - name: sort in: query description: Any of these values (revenueCode,-revenueCode,tobCode,-tobCode) are allowed. required: false schema: type: array items: type: string default: - revenueCode - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetches revenue codes for corresponding procedure code content: application/json: example: content: - revenueCode: '0456' revenueCodeDesc: Emergency Room-Urgent Care tobCode: '013' tobCodeDesc: Hospital Outpatient note: Clinic or ED Visit. Paid a separate APC. - revenueCode: '0510' revenueCodeDesc: Clinic-General classification tobCode: '013' tobCodeDesc: Hospital Outpatient note: Clinic or ED Visit. Paid a separate APC. totalCount: 2 '400': description: Bad request content: application/json: example: error: - sort parameter value should be from list of [revenueCode, -revenueCode, tobCode, -tobCode] warning: null info: null '500': description: Internal server error content: application/json: example: timestamp: '2023-07-27T08:10:07.573+00:00' status: 500 error: Internal Server Error message: 'Request processing failed: java.lang.IllegalArgumentException: Page size must not be less than one' path: /optumcommonms/api/optum/facility/procedure-revenue-codes/99213?page=-1 security: - bearerAuth: [] /api/optum/facility/cpt-hcpcs-required-revenue: get: tags: - Revenue Codes API summary: Fetches revenue codes requiring CPT HCPCS operationId: getCptHcpcsRequiredRevenueCodes parameters: - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: limit in: query required: false schema: type: integer format: int32 default: 50 - name: sort in: query description: Any of these values (code,-code) are allowed. required: false schema: type: array items: type: string default: - code - name: filter in: query required: false schema: type: string - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetches revenue codes requiring CPT HCPCS content: application/json: example: content: - code: 0278 description: Medical/Surgical Supplies and Devices hasProcedureCodes: true rangeDescription: Ancillary Services subCategoryAbbr: SUPPLY/IMPLANTS subCategoryDes: Other Implants - code: 0291 description: Durable Medical Equipment (Other than renal) hasProcedureCodes: true rangeDescription: Ancillary Services subCategoryAbbr: DME-RENTAL subCategoryDes: Rental totalCount: 2 '400': description: Bad request content: application/json: example: error: - sort parameter value should be from list of [code, -code] warning: null info: null '500': description: Internal server error content: application/json: example: timestamp: '2023-07-27T08:10:07.573+00:00' status: 500 error: Internal Server Error message: 'Request processing failed: java.lang.IllegalArgumentException: Page size must not be less than one' path: /optumcommonms/api/optum/facility/cpt-hcpcs-required-revenue?page=-1 security: - bearerAuth: [] /api/optum/facility/all-revenue-codes: get: tags: - Revenue Codes API summary: Fetches all revenue codes table data operationId: getAllRevenueCodes parameters: - name: page in: query required: false schema: type: integer format: int32 default: 1 - name: limit in: query required: false schema: type: integer format: int32 default: 50 - name: sort in: query description: Any of these values (code,-code) are allowed. required: false schema: type: array items: type: string default: - code - name: filter in: query required: false schema: type: string - name: yyyy-MM-dd in: header description: Date for which historical data is required required: false schema: type: string format: yyyy-MM-dd responses: '200': description: Fetches all revenue codes table data content: application/json: example: content: - code: '0000' description: Reserved hasProcedureCodes: false - code: '0001' description: Total Charges (reportable on paper claims only) hasProcedureCodes: false totalCount: 1232 '400': description: Bad request content: application/json: example: error: - sort parameter value should be from list of [code, -code] warning: null info: null '500': description: Internal server error content: application/json: example: timestamp: '2023-07-27T08:10:07.573+00:00' status: 500 error: Internal Server Error message: 'Request processing failed: java.lang.IllegalArgumentException: Page size must not be less than one' path: /optumcommonms/api/optum/facility/all-revenue-codes?page=-1 security: - bearerAuth: [] components: securitySchemes: bearerAuth: type: http scheme: bearer bearerFormat: JWT x-readme: explorer-enabled: true proxy-enabled: true